Child-Parent Screening (CPS) pilot for FH
This pilot was undertaken to enable an evaluation of a research study that was conducted by Professor David Wald approximately ten years ago, which explored whether the process of CPS is still fit for purpose in primary care which has radically changed over the years.
With parental consent, a child is tested for FH at their routine one-year immunisation appointment using a point of care heel prick capillary test.
Evidence shows that age one is when cholesterol measurement discriminates best between individuals with and without FH, so screening new-borns or adults is less effective. A small blood sample is taken and from this total cholesterol can be measured.
In those children with a reading of >95 percentile, further genetic testing can be undertaken. If the child receives a diagnosis of FH, at least one of the parents will also be positive, so testing is undertaken. Siblings and second-degree relatives can also be counselled and screened. Age-appropriate medication and advice can then be offered to families to reduce the risk of cardiac disease.
Health Innovation West of England supported the pilot with the recruitment of practices to undertake Child Parent Screening. Overall, 15 practices were onboarded and as of August 2024 over 550 patients have been screened.
To find out more about FH please see our lipids/FH section.
InHIP projects Wave 1 can be found here InHIP Wave 1 projects
Lipids optimisation
The Health Innovation Network’s lipids optimisation programme was part of a package of work delivered in partnership with the 2021/22 Rapid Uptake Products (RUP) programme which focused on: High Intensity Statins, Ezetimibe and PCSK9 inhibitors.
Health Innovation West of England worked with Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care Board and local GP practices to use search options within practice databases to identify patients at risk of raised cholesterol who would benefit from a detailed medication review. Using the pathway, the pilot identified 444 patients eligible for medication reviews, and of those 7 were referred to secondary care for PCSK9i therapy. The pilot was successful in ensuring hundreds of patients across the region were taking the most effective CVD medication. Read more about our work across BNSSG to optimise lipids, and increase use of PCSK9i therapy for eligible patients.
Inclisiran
Until recently if a patient was on the maximum dosage of statins, had been prescribed Rapid Uptake Products such as ezetimibe or PCSK9i and their cholesterol levels were not decreasing, options were limited. But now inclisiran can support these patients. Inclisiran was made accessible to patients through the first NHS ‘population health agreement’.
Inclisiran injections use a biological process where molecules can shut down protein translation to help the liver remove harmful low density lipoprotein cholesterol (which are often simply referred to as ‘bad cholesterol’) from the blood. Inclisiran can be used with statins or on its own. Read NICE guidance on the use of inclisiran.
The Accelerated Access Collaborative are responsible for the implementation of the inclisiran partnership with the Health Innovation Network, working to ensure inclisiran fits seamlessly into the updated lipids care pathway.
If you’re a healthcare professional, you can read summary information on the supply and funding of inclisiran from NHS England.
Uptake of inclisiran is above average in the West of England.
